Rapid Action Drug Alerts and Response (RADAR) quarterly report
January 2024
Management information
- Published
- 30 January 2024
- Type
- Statistical report
- Author
- Public Health Scotland
Trends
Police drug trends bulletin
This bulletin contains photos of drugs.
This update provides information on detections of MDMA and 'tusi', and legal changes related to nitrous oxide.
This information has been provided by Police Scotland’s Statement of Opinion (STOP) Unit to raise awareness of drug appearance and to demonstrate some of the substances present in Scotland's drugs market.
MDMA
The STOP Unit continues to see recoveries of both MDMA crystal and tablets (ecstasy) on a regular basis. MDMA is a class A controlled drug within the provisions of the Misuse of Drugs Act 1971.
The below are images of MDMA tablets recovered in August 2023 by events venue security staff in the West of Scotland. Some of these tablets have been reported to be linked to the deaths of young people.
2-CB
2-CB tablets were also seized in the West of Scotland. 2-CB is a psychedelic. It is a class A controlled drug within the provisions of the Misuse of Drugs Act 1971.
Nitrous oxide
On 8 November 2023, nitrous oxide was classified as a class C controlled drug within the provisions of the Misuse of Drugs Act 1971, having previously been governed under the Psychoactive Substances Act 2016.
Nitrous oxide is also known as 'laughing gas'. It is a colourless gas that is commonly found in metal pressurised canisters, known as chargers or tanks. The gas is released into a balloon using a dispenser, nozzle or cracker and then inhaled.
'Tusi'
'Tusi,' also known as 'tusibi', 'tuci', and 'pink cocaine', is a pre-mixed combination of drugs. The composition of 'tusi' varies widely in the illicit market. It may include a variety of drugs such as MDMA, 2-CB, LSD, ketamine, cathinones and cocaine, mixed with pink food colouring.
This is a drug that has been in and around the illicit drugs market for some time, however, it is not very common. Some Drug Trend Monitoring Groups in Scotland have reported that they have seen a rise in this commodity recently. The STOP Unit will continue to liaise with partner agencies on any emerging trends and recoveries.
RADAR intelligence and reports
53 reports were validated by RADAR between 5 October 2023 and 4 January 2024.
So far, RADAR has received over 150 reports of drug-related information and harms received through the reporting form and mailbox.
A summary of key trends is shown below. Validated intelligence reports to RADAR can be found on the dashboard (external website).
Please note, many of these reports have not been confirmed by toxicology and should be considered anecdotal.
Trends by primary drug type
- In the latest period (5 October 2023 to 4 January 2024)
- The most common drugs or drug types reported were:
- benzodiazepines
- cocaine
- heroin
- new synthetic opioids including nitazenes
- tapentadol and/or carisoprodol tablets ('somas' and 'red apples')
- ketamine
- MDMA (ecstasy)
- Half of reports mentioned polydrug use – the use of more than one substance at a time.
- The most commonly reported concerns were related to adverse effects, overdose and deaths.
Key trends
RADAR is currently assessing the harms related to cocaine and ketamine, nitazene-type opioids and xylazine.
Concern: Cocaine and ketamine being taken together and more reports of ketamine use among young people.
Drug(s): Cocaine is a short-lasting stimulant drug. Ketamine is a dissociative drug.
Legal status: In the UK, cocaine is a class A drug and ketamine is class B, under the Misuse of Drugs Act 1971.
Summary
Reports from several areas of cocaine and ketamine being taken together called 'Calvin Klein', 'CK' or 'CK1', or 'KitKat' less commonly. This is reported to have been particularly prevalent among young people since the start of 2022.
Further information
- The concurrent use of ketamine and cocaine can lead to adverse effects including mental health issues such as anxiety, paranoia and hallucinations.
- Long-term ketamine use can result in urinary tract problems.
- Cocaine can result in cardiovascular problems.
- Cocaine can dull the effects of ketamine resulting in higher doses being taken. This can increase the risk of negative side effects from both drugs and can increase strain on the body, especially on the heart.
Harm reduction
- Avoid mixing substances including alcohol. If mixing, take less of each substance than if you were only taking one. Don’t mix them in the same bag or line.
- Leave a long gap between doses.
- Be mindful of the environment you are in. Ketamine can affect your coordination.
- Have someone not taking drugs around who can respond in an emergency.
- If experiencing chest pain, abdominal pain, difficulty urinating or blood in urine, seek medical help.
Concern: Nitazenes increasingly detected in overdoses and deaths in Scotland
Drug: Nitazenes. A group of potent synthetic opioids.
Legal status: In the UK, clonitazene and etonitazene are classified as class A drugs under the Misuse of Drugs Act 1971. The UK government plans to soon control another 15 nitazenes as class A drugs.
Summary
- Reports to RADAR show an ongoing increase in the availability and detections of nitazenes, most commonly metonitazene and protonitazene.
- They are increasingly detected in the wider drugs market, including in drugs sold as benzos, heroin and oxycodone.
Further information
- A public health alert about nitazene-type opioids (published in January 2023) was updated in December 2023 to include provisional data on detections of nitazenes in deaths in Scotland. Based on post-mortem toxicology testing, nitazenes were detected in 25 deaths (to 30 September 2023).
Concern: Xylazine increasingly detected in overdoses and deaths in Scotland
Drug: Xylazine. A depressant drug used in veterinary medicine with sedative, analgesic and muscle relaxant properties.
Legal status: In the UK, xylazine is not controlled by the Misuse of Drugs Act 1971. The supply and importation of xylazine is controlled by the Psychoactive Substances Act 2016.
Summary
- Toxicology reports to RADAR show a rapid increase in detections of xylazine.
- Until 2023 there were only two reports of xylazine in Scotland:
- January 2020, East Ayrshire, white powder, sold as ketamine
- June 2022, Fife, colourless liquid, sold as THC vape liquid
- Xylazine was first detected in both post-mortem toxicology and in the ASSIST hospital toxicology project in July 2023. Since then, it has been detected 14 times.
- It is commonly co-detected alongside heroin, benzodiazepines, codeine and nitazenes (most commonly protonitazene and metonitazene).
- Xylazine has also been detected by WEDINOS in samples mis-sold as heroin in Lothian and the Scottish Borders.
Further information
- Due to its unexpected presence in the drug supply and depressant effects, xylazine poses a substantial risk of overdose, hospitalisation and death, especially when taken in combination with other depressants.
- Xylazine use is associated with the development of severe wounds and skin damage, regardless of how it is administered. Wounds can appear anywhere on the body and look like blisters, bruises or open sores. Medical care is required if the wound continues to grow or does not heal. Any increase in wound-related presentations can be reported to NHS Health Protection Teams and RADAR.
Reporting drug harms
Please encourage people and services in your area to share information on trends, incidents and harms related to drugs, such as:
- adverse effects including overdose and wounds
- routes of administration
- new substances or patterns of use
- testing data.
The information in the regional breakdown can be used by local areas for their own drug trend surveillance.
Anyone can make a report by using our reporting form or by emailing the mailbox.